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Related Experiment Video

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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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Pulmonary vasospasm in systemic sclerosis: noninvasive techniques for detection.

Gregory J Keir1, Arjun Nair2, Stamatia Giannarou3

  • 1Royal Brompton Hospital, London, United Kingdom ; Princess Alexandra Hospital, Brisbane, Australia.

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|September 25, 2015
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Summary

Systemic sclerosis patients sensitive to cold air showed reduced pulmonary blood flow after a cold air challenge, suggesting pulmonary vasospasm. This may explain worsening respiratory symptoms in some SSc patients exposed to cold.

Keywords:
noninvasivepulmonary vasospasmscleroderma

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Area of Science:

  • Cardiovascular and Respiratory Medicine
  • Radiology and Imaging

Background:

  • Systemic sclerosis (SSc) can lead to pulmonary vasospasm, worsening dyspnea.
  • Noninvasive methods like inert-gas rebreathing (IGR) and dual-energy CTPA can assess pulmonary blood flow (PBF).

Purpose of the Study:

  • To investigate pulmonary blood flow changes in systemic sclerosis patients after cold air challenge.
  • To identify potential pulmonary vasospasm in SSc patients sensitive to cold air.

Main Methods:

  • Thirty-one participants (22 SSc patients, 9 healthy volunteers) underwent PBF assessment using IGR and DE-CTPA.
  • Participants were categorized into SSc patients with cold air sensitivity (Group A), SSc patients without (Group B), and healthy controls (Group C).
  • PBF was measured at baseline and after a cold air challenge (CACh).

Main Results:

  • Group A (SSc with cold sensitivity) exhibited a significant decline in PBF post-CACh at 10, 20, and 30 minutes compared to Groups B and C.
  • No significant PBF changes were observed between Group B and Group C.
  • Dual-energy CTPA showed no changes in pulmonary perfusion.

Conclusions:

  • Reduced pulmonary blood flow after CACh in a subgroup of SSc patients suggests the presence of pulmonary vasospasm.
  • Pulmonary vasospasm may contribute to increased dyspnea upon cold exposure in these patients.